胰岛素促泌剂与阿卡波糖治疗新诊断2型糖尿病的疗效及对胰升血糖素样肽-1的调节作用  

The efficacy and regulation of insulin secretagogues and Acarbose on glucagon-like peptide-1 in newly diagnosed type 2 diabetes

作　　者：樊实真[1] 杨俊朋[2] 张春玲[3] 马跃华[2] 袁慧娟[2] 赵志刚 

机构地区：[1]郑州市第一人民医院内分泌与代谢科,450004 [2]河南省人民医院内分泌与代谢科 [3]河南财经政法大学外国语系 [4]郑州颐和医院

出　　处：《中国糖尿病杂志》2016年第4期348-351,共4页Chinese Journal of Diabetes

摘　　要：目的观察胰岛素促泌剂及阿卡波糖对血浆胰升血糖素样肽-1(GLP-1)、胰升血糖素(GC)的影响。方法选取新诊断T2DM患者127例,随机分为格列本脲(GG)组34例、瑞格列奈(RG)组32例、阿卡波糖(AG)组31例及西格列汀(SG)组30例。治疗12周,观察各组血糖、HbA_1c、GLP-1及GC的变化。结果各组治疗后FPG、2 hPG、HbA_1c均降低,GG组和RG组△HbA_1c高于AG组和SG组(P<0.05);AG组和SG组治疗后FGLP-1、2 hGLP-1升高,FGC、2 hGC降低(P<0.05);GG组和RG组治疗后空腹GLP-1(FGLP-1)、2 hGLP-1、空腹GC(FGC)及2 hGC与治疗前比较,差异无统计学意义(P>0.05);SG组ΔFGLP-1、2 hGLP-1及ΔFGC均高于AG组(P<0.05)。结论格列本脲和瑞格列奈降糖效果优于西格列汀和阿卡波糖。西格列汀与阿卡波糖均能升高血浆GLP-1,降低GC水平。格列本脲和瑞格列奈无调节GLP-1和GC的作用。Objective To investigate the influence of insulin secretagogues agent and acarbose on plasma glucagon-like peptide-1（GLP-1） and glucagon（GC） when used for monotherapy in newly diagnosed type 2 diabetes（T2DM）.Methods A total of 127 newly diagnosed T2 DM patients were recruited and then randomly divided into four groups：Glibenclamide group（GG,n=34）.Repaglinide group（RG,n= 32）,Acarbose group（AG,n= 31）,Sitagliptin group（SG,n = 30）.The changes of glucose,HbA1c GLP-1 and GC levels among different groups were compared after 12 weeks treatment.Results After the treatment,the levels of FPG,2 hPG and HbAic were significantly reduced in each group.Compared with AG group and SG group,the decrease of HbA1c in GG group and RG group were statistically significant（all P〈0.05）.The increase of FGLP-1 and 2 hGLP-1 and the decrease of FGC and 2 hGC were significant after treatment in AG group and SG group（all P〈0.05）.The levels of FGLP-1,2 hGLP-1,FGC and 2 hGC had no significant differences after treatment in GG group and RG group（all P〉0.05）.Compared with SG group,the increase of FGLP-1,2 hGLP-1 and the decrease of FGC in AG group were statistically significant（all P〈0.05）.Conclusion The hypoglycemic effect of Glibenclamide and Repaglinide are better than that of Sitagliptin and Acarbose.Sitagliptin and Acarbose could increase the level of plasma GLP-1 and decrease the level of GC;Glibenclamide and Repaglinide do not have the effect of regulating GLP-1 and GC.

关 键 词：糖尿病 2型 西格列汀 阿卡波糖 胰岛素促泌剂 胰升血糖素 胰升血糖素样肽-1 

分 类 号：R587.1[医药卫生—内分泌]